腹腔镜远端胃癌D2根治手术的路径

Operation Path in Laparoscopic Gastrectomy with D2 Lymphadenectomy for Distal Gastric Cancer

目的:探讨腹腔镜远端胃癌D2根治术的合理手术路径。方法:分析23例行腹腔镜远端胃癌D2根治手术治疗的手术路径。结果:23例中22例完成腹腔镜手术,手术时间平均(232±35)min,术中出血平均(130±50)mL,平均清扫淋巴结(19±5)枚,术后胃肠功能恢复时间2～4d。结论:腹腔镜远端胃癌D2根治手术遵循从下到上、从右到左、从胃大弯到胃小弯的操作顺序是合理、可行的,淋巴清扫时,胰腺是手术操作的主要解剖定位标志,胃十二指肠动脉是最重要的血管定位标志。

Objective To study the operation path m laparoscop^t： ~a^L ： J---f for distal gastric cancer. Methods The operation path was analysed in 23 patients undergoing laparoscopic gastrectomy with D2 lymphadenectomy for distal gastric cancer. Results Twenty two patients ufiderwent lapa- roscopic radical gastrectomy. The average operation time was （232＋_35） min, mean blood loss was （130＋50） mL, average harvested lymph nodes was 19＋5, and mean time for gastrointestinal function recovery was 2~4 days. Conclusion The sequence of procedure of from bottom to top, from right to left, from the greater curva- ture to the lesser curvature in laparoscopic gastrectomy with D2 lymphadenectomy for distal gastric cancer is rea- sonable and feasible. The pancreas is the main operating anatomic landmark; the gastroduodenal artery is the main vascular landmark.